AB Medical Services is operated by AB Medical Services (UK) Limited. The independent ambulance service provides event medical cover, patient transport services and patient repatriation services.

We inspected this service using our comprehensive inspection methodology. We carried out this announced inspection on 26 September 2017.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the service understood and complied with the Mental Capacity Act 2005.

Services we do not rate

The main facility provided by this service was event medical cover. However, CQC does not currently have the power to regulate event medical cover. A small proportion of the activity provided by the service were patient transport services and self-funded repatriations. These activities are regulated by CQC.

We regulate independent ambulance services but we did not have a legal duty to rate them at the time of this inspection. We highlight good practice and issues that services need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• Staff showed an understanding of the incident reporting system and the importance of reporting incidents.

• The service was very well equipped with equipment and consumable medical supplies that were appropriately sealed and in date.

• There were systems to ensure vehicles were checked and maintained regularly. We saw certificates reflecting that all vehicles complied with MOT testing, were insured and had been taxed.

• The service had good medicines management and good security for medicines and supplies.

• We saw evidence that both equipment on the ambulance and auxiliary equipment had comprehensive annual testing and servicing by an engineer. The engineer’s feedback sheet from the most recent tests in March 2017 reflected that all equipment passed inspection.

• The service was prepared to respond to a major incident with trained staff and a well-equipped ambulance.

• Staff had access to evidence-based guidance.

• The service ensured staff had base line competency before offering employment and supported ongoing staff competency through regular auditing, training and appraisals.

• Staff worked with other medical staff from other services to share care and information.

• Patient feedback was positive.

• Staff ensured dignity in public places for vulnerable patients.

• Staff were prepared to meet the needs of individual patients, for instance children and young people and those with communication and learning difficulties.

• The service reported that they had received no written or verbal service user complaints during the twelve-month reporting period prior to the inspection.

• Staff we spoke to understood the service’s mission and readily told us the service was led by these values.

• Staff were proud to work for the service and felt they gave patients a high standard of service and care.

• The senior managers were very visible and accessible. They performed operational duties and were regularly at events working with staff as a senior team member or team leader.

However, we also found the following issues that the service should improve:

• Senior staff were not familiar with the duty of candour, although they were all able to discuss the importance of open and transparent communications with patients and family members.

• The service’s training tracker reflected that only four out of eight staff members (50%) had completed their infection control training. This meant staff might not have up to date knowledge regarding infection control to protect patients.

• The service used a system of policies and audit to ensure the delivery of strategy and care, but did not have a robust system to manage risks or a system to ensure policies were regularly reviewed.

At the inspection, we reported to the service that the following issues needed to improve:

• The safeguarding lead was not trained to adult and child safeguarding level 3 in line with intercollegiate guidance.

• Bag valve masks (BVMs) were out of date having expired in 2015.

• Children under age two could not be transported safely as the service did not have equipment to safely transport this group.

The provider took steps immediately and provided evidence that they had improved these issues within ten working days of the day of inspection, these are outlined within the report. Details of steps we are still asking the provider to take are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (South), on behalf of the Chief Inspector of Hospitals